<html>
<head>
{php}html_header_show();{/php}

</head>
<body style="padding: 0; background: none repeat scroll 0px 0px rgb(249, 249, 249);">
<div class="borde_normal" style="padding: 0px;"><p><span class="historial_paciente"><i class="icon-file-text-alt" style="font-size: 1.2em;"></i> {php} echo 'Consulta'; {/php}</span></p></div>
<form name="soap" method="post" action="{$FORM_ACTION}/interface/forms/soap/save.php"
 onsubmit="return top.restoreSession()">
<table>
	<tr>
		<td align="left" style="padding-right: 20px;text-align: right; width: 145px;width: 25%;">{php} echo 'Motivo de la consulta:'; {/php}</td>
		<td width="90%">
			<textarea name="motivo" cols="60" rows="4">{$data->get_motivo()}</textarea>
		</td>
	</tr>
	<tr>
		<td align="left" style="padding-right: 20px;text-align: right; width: 145px;width: 25%;">{php} echo 'Enfermedad Actual:'; {/php}</td>
		<td width="90%">
			<textarea name="subjective" cols="60" rows="4">{$data->get_subjective()}</textarea>
		</td>
	</tr>
	<tr>
		<td align="left" style="padding-right: 20px;text-align: right; width: 145px;width: 25%;">{php} echo'Examen F&iacutesico:'; {/php}</td>
		<td width="90%">
			<textarea name="objective" cols="60" rows="4">{$data->get_objective()}</textarea>
		</td>
	</tr>
	<tr>
		<td align="left" style="padding-right: 20px;text-align: right; width: 145px;width: 25%;">{php} echo 'Concepto:'; {/php}</td>
		<td width="90%">
			<textarea name="concepto" cols="60" rows="4">{$data->get_concepto()}</textarea>
		</td>
	</tr>	
	<tr>
		<td align="left" style="padding-right: 20px;text-align: right; width: 145px;width: 25%;">{php} echo 'Plan de manejo:'; {/php}</td>
		<td width="90%">
			<textarea name="assessment" cols="60" rows="4">{$data->get_assessment()}</textarea>
		</td>
	</tr>
	<tr>
		<td align="left" style="padding-right: 20px;text-align: right; width: 145px;width: 25%;">{php}echo "Conducta a seguir:" {/php}</td>
		<td width="90%">
			<select name='conducta' id='conducta'>
				<option value='_blank'><?php xl('Select One', 'e'); ?></option>
				{php}
				
					$cres = sqlStatement("SELECT * FROM `list_options` WHERE list_id = 'Conducta_a_seguir' order by seq asc");
					while ($crow = sqlFetchArray($cres)) {
						echo "       <option value='".$crow['seq']."'";
						if( $crow['seq'] == $result['pc_conductid'] ) echo " selected ";
						echo ">" . $crow['title'] . "</option>\n";
					}
				
				{/php}
			</select>
		</td>
	</tr>
	<tr>
		<td></td>
    <td></td>
</tr>
<tr>
		<td></td>
    <td></td>
</tr>
	<tr>
		<td></td>
    <td><input type="submit" class="css_button" name="Submit" value={php} xl('Save Form','e','"','"'); {/php}</td>
	</tr>
</table>
<input type="hidden" name="id" value="{$data->get_id()}" />
<input type="hidden" name="activity" value="{$data->get_activity()}">
<input type="hidden" name="pid" value="{$data->get_pid()}">
<input type="hidden" name="process" value="true">
</form>
</body>
</html>
